VETgirl Q3 2019 Beat e-Newsletter

RESUSCITATION OF THE NEONATE AFTER C - SECTION ERIN SPENCER, M.ED., CVT, VTS ( ECC )

In this VETgirl Real Life Rounds, “Resuscitation of the Neonate after C-Section,” Erin Spencer, M.Ed., CVT, VTS (ECC) reviews the important considerations both leading up to delivery of newborn puppies and kittens and during resuscitation e ff orts to ensure the best outcome.

KEY HIGHLIGHTS

• Both the dam and queen experience a relative anemia that is at its lowest when at term. This anemia is due to an increase in plasma within the blood. With this drop in the number of RBCs/ µ l of blood volume, oxygen delivery is somewhat compromised. • The dam/queen’s functional residual capacity (FRC) is lessened as their diaphragm becomes pushed cranially due to growing fetuses. While the

PHYSIOLOGIC CONSIDERATIONS OF DAM/QUEEN 1 The first thing to consider when a dam/queen presents for treatment of dystocia is her anxiety or stress level. Increased stress and anxiety can lead to a catecholamine release which results in decreased blood flow to the uterus and, ultimately, the fetus. • Upon presentation, some accommodations that may help keep stress levels at a minimum are keeping the dam/queen with owners in an exam room. • Decrease noise levels through utilizing an exam room (or other room) that is as removed as possible from the bustle of the front desk or the treatment area. • Pre-medication should be considered in cases where the dam/queen is significantly stressed/anxious whether due to the situation or due to pain. While minimizing the amount of drugs the fetuses will be exposed to is a major concern during C-section, this needs to be balanced with the e ff ects of maternal stress on the unborn fetus. 2 Oxygen figures prominently in considerations of the dam/queen.

body makes accommodations for these changes during pregnancy, ventilation can become compromised, especially when the dam/queen is placed in certain positions, such as dorsal recumbency. Dorsal recumbency should be minimized as much as possible when preparing for C-section.

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